Intravascular lithotripsy-assisted Impella insertion: A case report.

Coronary and peripheral arterial calcification increases the complexity of percutaneous treatment strategies in both coronary and peripheral interventions. The first use of intravascular lithotripsy (IVL) using the Shockwave IVL device (Shockwave Medical Inc) in femoropopliteal arteries for modification of calcified plaque was recently described. We present a case illustrating use of the device to deliver a 14 French sheath for delivery of an Impella mechanical circulatory device prior to high-risk percutaneous coronary intervention (PCI). This case illustrates that IVL may be used to facilitate a broadening array of procedures in the catheterization laboratory, including the delivery of large bore sheathes.